How much rates vary
Facilitymedian $3,090 · 10th to 90th $741 to $8,913Professionalmedian $407 · 10th to 90th $302 to $575
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $11,481.54 | Facility | None | $331.13 | $457.09 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $457.09 | Professional | None | $316.23 | $316.23 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | None | $389.05 | $389.05 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,174.90 | $5,248.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $549.54 | Professional | None | $281.84 | $407.38 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $616.60 Typical High $831.76 | Professional | 50 · Both sides | $416.87 | $616.60 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $1,995.26 | Facility | None | $331.13 | $331.13 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,584.89 Typical High $2,818.38 | Facility | None | $776.25 | $1,584.89 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $660.69 | Professional | None | $309.03 | $398.11 | $660.69 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $3,801.89 | Facility | None | $891.25 | $2,137.96 | $3,801.89 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $616.60 | Professional | None | $331.13 | $407.38 | $616.60 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $7,943.28 | Facility | None | $1,000.00 | $3,311.31 | $7,943.28 |
United Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $602.56 | Professional | None | $309.03 | $380.19 | $602.56 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $263.03 |
Where Indiana sits
The same service costs 5.1 times more in Oklahoma than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
OK $5,094MT $991
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.